Objective - To explore the perceptions of physical activity and healthy eating among children from two north west of England primary schools, with the ultimate aim of improving healthy lifestyle choices.

Design - A qualitative study in which each child participated in two focus groups.

Setting Two primary schools in a deprived ward of Warrington, chosen to contrast with the focus of earlier research on relatively affluent communities.

Method - A sample of 32 9 and 10 year olds was randomly selected from two Year 5 classes. Four focus groups were held in total; two in each school. The first explored perceptions of physical activity and the second examined views on food and eating. Discussions were recorded, transcribed verbatim and findings emerged through a process of thematic analysis.

Results - Children reported being involved in a range of physical activities and recognized the health benefits associated with being active. Boys and girls differed in their attitude towards physical activity, with boys appearing competitive about sport while girls enjoyed a wider range of activities. Children were able to distinguish between healthy and unhealthy foods, but there was uncertainty over the healthiness of foods containing multiple ingredients (for example, salad in burgers). Children also identified the impact of the local environment, parents, school, the food industry and their peers on their diet and involvement in physical activity.

Conclusions - Children receive contradictory messages about food and diet, which they make sense of through their social interactions. The development of obesity prevention strategies and weight management programmes must take into account children's perspectives. Children should be given the opportunity to contribute to the development of initiatives that are set up to prevent and treat obesity.